Revenue Reconciliation Analyst - Hybrid/Medicaid at Centene

Ideal for someone with at least two years of experience in reconciliation, auditing, accounting, or analytics, this mid-level role requires a High School diplom

Work type: hybrid

Location: Pittsburgh - 48 26th Street (11161)

Salary: $19 – $33/hr

Type: Full-time

Summary

Ideal for someone with at least two years of experience in reconciliation, auditing, accounting, or analytics, this mid-level role requires a High School diploma or GED, though a Bachelor's degree in a related field can substitute for two years of experience. **What makes it worth a look...** Centene, a national healthcare organization, is offering a hybrid role with a pay range of $19.43 - $32.98 per hour, requiring two days a week in their Pittsburgh office at 48 26th Street. **You might be a good fit if you...** * Reconcile enrollment and revenue data between internal and external systems. * Analyze and validate 834 enrollment and 820 payment data. * Possess knowledge of Medicaid, Medicare, and dual eligibility. * Have experience handling high-volume outreach calls.

Job Description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

## This is a hybrid role that requires 2 days a week in the office at location:

## 48 26th Street, Pittsburgh, PA Position Purpose: With the PA Health and Wellness Medicaid reconciliations team, this role supports initiatives by conducting targeted outreach and screening to members via telephone for healthcare alignment opportunities, educating members, and facilitating seamless referrals to drive enrollment and improve overall member outcomes.

• Conduct 30-to-60-day outreaches to participants to ensure they have completed or are in the process of completing their redetermination packets for the state.


• Outreach participants to assess participant interest in dual alignment and route qualified referrals to the Medicare Advantage team, ensuring timely follow-up and continuity of care coordination.


• Reconcile enrollment and revenue data between internal systems and external sources (e.g., state systems).


• Analyze and validate 834 enrollment data and 820 payment data to ensure accuracy.


• Collaborate with cross-functional teams to correct data inconsistencies.


• Maintain accurate documentation and reconciliation processes, findings, and resolutions.

• Strong customer service and member engagement skills, with the ability to build trust and communicate complex healthcare information clearly.


• Knowledge of Medicaid, Medicare, and dual eligibility.


• Ability to educate participants on plan benefits and guide them through decision making without being sales driven.


• Excellent communication skills (Phone, email, and documentation) with professional and empathetic approach.


• Experience handling high volume outreach calls.


• Basic analytical skills to review member data.


• Ability to manage time effectively, meet performance metrics, and follow structured workflows.

• Required Education: High School or GED or


• Preferred Education: Bachelor's degree in a related field and may substitute for 2 years' experience in any combination of Reconciliation, Auditing, Accounting or Analytics


• RequiredExperience: 2+ years of experience in any combination of Reconciliation, Auditing, Accounting or Analytics

• Preferred Experience: 1+ year of experience in government payer system, Health insurance experience, Xcyels experience

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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